This study aimed to assess characteristics of healthcare networks in four large Brazilian cities (Campinas, Fortaleza, Porto Alegre, and São Paulo), in the provision of mental healthcare. The following outcomes were used (i) place of identification of the mental health problem; (ii) mental healthcare in primary care; (iii) pharmaceutical care in mental health; and (iv) social rehabilitation. This is a mixed-methods study with a concurrent and sequential approach, conducted with 10 administrators and 1,642 users of Centers for Psychosocial Care (CAPS, in Portuguese) in the four cities. The study showed the persistence of high-complexity services such as hospitals as the site for initial identification of mental health problems in Campinas (40% of users) and Fortaleza (37%); low proportion of mental health treatment in primary care (Fortaleza, 23%); differences between cities in psychotropic medication prescription in primary care (Porto Alegre, 68%; São Paulo, 64%; Campinas, 39%; Fortaleza, 31%) and in shortages of prescribed medication (higher in Fortaleza, 58%; lower in Campinas, 28%); and overall frailty in enabling return to work (lower in São Paulo, 17%; higher in Campinas, 39%), with better overall results regarding religion and leisure activities (higher in São Paulo, 53% and 56%, respectively). The study contributes to the discussion of the Brazilian scenario of mental healthcare, with evidence of persistent inequalities in the national context, pointing to gaps in some mental healthcare network configurations with the potential for better performance and longitudinal follow-up.Smoking is the main cause of avoidable death and a major public health problem worldwide, with primary healthcare being a strategic setting for treating this problem. Aims to evaluate the effectiveness of motivational interviewing associated with the cognitive behavioral therapy (CBT) in smoking groups in primary healthcare. A community-based cluster randomized clinical trial was conducted in Brazil, starting in July 2016. Professionals in the test group were trained in motivational interviewing for eight hours to associate it with the CBT. The usual treatment for smoking cessation in groups consists of four structured weekly sessions of 90 minutes each using a CBT. Taylor's linearization was used to correct the p-values; the chi-square test with Pearson correlation was used for categorical variables, and analysis of variance as well as the Student t-test were used for continuous variables. In total, 44 smoking groups were conducted, totaling 329 patients (178 in the motivational interviewing group and 151 in the control group). The smoking cessation rate with motivational interviewing was 61.8%, with RR = 1.25 (95%CI 1.01-1.54, p = 0.043), and 47.7% in the control group, in the fourth weekly group treatment session. Mean session attendance was 3.1 (95%CI 2.9-3.3) in the motivational interviewing group and 2.9 (95%CI 2.5-3.4) in the control group. The completion rate for the motivational interviewing group was 65.2% and for the control group, 57.6%. Motivational interviewing associated with the CBT was shown to be effective and superior to only CBT to smoking cessation in groups in the fourth weekly session and for the population profile of the study (women with an average age of 50.6 years).Living with chronic kidney disease (CKD) is associated with hardships for patients and their care-partners. Empowering patients and their care-partners, including family members or friends involved in their care, may help minimize burden and consequences of CKD-related symptoms to enable life participation. There is a need to broaden the focus on living well with kidney disease and re-engagement in life, including emphasis on patients being in control. The World Kidney Day (WKD) Joint Steering Committee has declared 2021 the year of "Living Well with Kidney Disease" in an effort to increase education and awareness on the important goal of patient empowerment and life participation. This calls for the development and implementation of validated patient-reported outcome measures to assess and address areas of life participation in routine care. It could be supported by regulatory agencies as a metric for quality care or to support labelling claims for medicines and devices. Funding agencies could establish targeted calls for research that address the priorities of patients. Patients with kidney disease and their care-partners should feel supported to live well through concerted efforts by kidney care communities including during pandemics. In the overall wellness program for kidney disease patients, the need for prevention should be reiterated. Early detection with prolonged course of wellness despite kidney disease, after effective secondary and tertiary prevention programs, should be promoted. WKD 2021 continues to call for increased awareness of the importance of preventive measures throughout populations, professionals, and policy makers, applicable to both developed and developing countries.Hypertension has long been recognised as a major risk factor for coronary artery disease, stroke and kidney disease. Despite a multitude of new pharmacological agents, in the Sudan, a significant proportion of hypertensive patients' blood pressure remains uncontrolled. https://www.selleckchem.com/products/cct241533-hydrochloride.html An important, often underutilised treatment approach is therapeutic lifestyle changes (TLC). This study aimed to assess the knowledge, attitude and practice of patients with regard to TLC in the management of hypertension in a Khartoum locality in 2016.
The study was cross sectional and descriptive. Data were collected via structured interviews using a questionnaire. Full coverage of patients attending Ahmed Gasim and Al-Shaab hospitals for follow up during August and September 2016 was carried out. Descriptive and inferential statistics were utilised for data analysis.
We identified 112 patients for participation in this study. There was a slight preponderance of females (54.5%) and older age, with 58% in the 55- to 70-year age group. Whhe importance of TLC in its management, they struggled to implement this. The researcher believes that novel approaches are needed to help motivate patients who are diagnosed with hypertension in a third-world country such as Sudan, and apply their knowledge regarding TLC.